胸壁巨大上皮样血管肉瘤的临床病理分析

目的探讨发生于胸壁上皮样血管肉瘤的临床病理特征、病理诊断及鉴别诊断。方法对1例原发于胸壁的上皮样血管肉瘤进行组织形态学、免疫组织化学分析,并复习相关文献。结果肿瘤大体形态有主瘤结及卫星瘤节的特点,镜下观察其瘤细胞呈上皮样排列,异型性明显,免疫组化结果显示Vim强阳性,CD31阳性,CD34阳性。结论发生于胸壁的上皮样血管肉瘤较少见,术前确诊较困难,须与原发于胸膜的恶性间皮瘤、转移癌、恶性黑色素瘤等鉴别。     

乳腺根治术继发淋巴水肿后上臂皮肤血管肉瘤1例及文献复习

目的探讨乳腺根治术继发淋巴水肿后的上臂皮肤血管肉瘤,即STS的临床病理学特征及诊断、鉴别诊断要点。方法对1例STS进行病理组织学及免疫组织化学染色观察,并复习相关文献。结果镜下以充满红细胞的大小不等的囊腔,相互沟通的不规则的管腔,部分由梭形和上皮样细胞构成的实性区域为特征。不规则的管腔内衬覆异型瘤细胞,可见单个或多个瘤细胞形成空腔内含红细胞。免疫组织染色肿瘤细胞CD34阳性、CD31阳性,Ki-67部分阳性,AE1/AE3为阴性表达。结论 STS是乳腺血管肉瘤的一种特殊类型,免疫组织化学检测有助于诊断和鉴别诊断。     

胰腺上皮样血管平滑肌脂肪瘤1例并文献复习

目的:探讨胰腺上皮样血管平滑肌脂肪瘤(EAML)的临床病理学特点.方法:回顾复习1例胰腺EAML的临床、影像学资料,并进行组织病理、免疫组织化学分析及相关文献的复习.结果:切片镜下,肿瘤细胞为上皮样或梭形,胞浆丰富,透明或颗粒状,嗜酸性,呈片状或巢状分布,围绕间质中丰富的薄壁窦性血管形成器官样结构,可见少量厚壁血管,部分区域脂肪组织散在分布,背景中可见大量炎细胞浸润.免疫表型:肿瘤细胞HMB45阳性、Vimentin阳性,SMA及CD68散在阳性,CD34血管阳性,CD117、Desmin、S-100、CgA及AE1/AE3均阴性.结论:胰腺EAML是一种少见的间叶性肿瘤,容易误诊,需于胰腺内分泌肿瘤、副节瘤等肿瘤相鉴别,免疫组织化学染色是诊断及鉴别诊断的重要方法.     

18例子宫腺瘤样瘤的临床病理特征分析

目的探讨子宫腺瘤样瘤的临床病理特点、发生、免疫组化表达特点及提高子宫腺瘤样瘤的诊断水平。方法对18例子宫腺瘤样瘤进行临床病理及免疫组织化学观察。以福尔马林固定、石蜡包埋、常规切片、HE染色,光镜观察;免疫组织化学用即用型抗体SP法染色法。结果 18例子宫腺瘤样瘤患者,临床表现无特诊性;免疫化显示:AE1/AE3、vimentin、calretinin阳性,ER、PR、CEA、CD31阴性。结论子宫腺瘤样瘤并非罕见,支持间皮起源,临床和病理检查均易误诊和漏诊。免疫组化可作为诊断和鉴别诊断的重要参考依据。     

脾窦岸细胞血管瘤的临床病理分析(附1例报告)

目的探讨脾窦岸细胞血管瘤的临床、影像学特征和病理组织学、免疫组织化学在诊断中的价值、鉴别诊断的要点及治疗方式。方法回顾性分析我院1例脾窦岸细胞血管瘤患者的临床资料,影像学的检查、大体及光镜观察、免疫组织化学方法检测及手术治疗的效果。结果脾窦岸细胞血管瘤的临床症状不典型,病理学特征性表现为:瘤结节位于脾红髓内,由相互吻合的血管腔构成,呈迷路样分布,常有假乳头样结构突入腔内,胞质内常见含铁血黄颗粒。免疫组化提示:FⅧRA g、CD 34、CD 68、CD 31、Lyso均为( ),患者手术切除脾脏取得良好临床疗效。结论脾窦岸细胞血管瘤是一种罕见的脾血管源性肿瘤。诊断主要依靠病理组织学及免疫组织化学,治疗主要是手术行脾脏切除,因可合并恶性肿瘤,应进行仔细检查及密切随访。     

骨多发性上皮样血管肉瘤的临床病理分析

目的探讨骨上皮样血管肉瘤的临床病理特征、诊断、鉴别诊断、治疗及预后。方法对1例骨上皮样血管肉瘤进行组织形态学观察及免疫组织化学染色分析,结合相关文献资料进行分析与总结。结果骨上皮样血管肉瘤镜下组织学表现为:肿瘤细胞为上皮样,呈巢状、条索状及丛状分布。易与低分化癌和其他上皮样肉瘤相混淆。免疫组织化学显示瘤细胞特异地表达CD31、CD34和FⅧ因子等血管源性标志物。结论骨上皮样血管肉瘤是一种罕见的肿瘤,具有高度侵袭性且往往迅速转移,预后很差。病理医师需仔细观察光镜下组织形态,并结合一组免疫组化标记,才能做出正确诊断。     

胃肠道间质瘤病理及免疫组化分析

目的 探讨胃肠道间质瘤(GIST)的临床病理、免疫组织化学特点.方法 应用常规病理观察36例GIST的形态特征,用免疫组织化学SP法检测CD34、CD117、vimentin、SMA、NSE、S-100蛋白在GIST中表达.结果 本组GIST镜下瘤细胞以梭形细胞和上皮样细胞为主,或两种混合存在,成束状、栅栏状、旋涡状或巢状排列.36例中良性12例,交界性14例,恶性10例.免疫组织化学表型CD34和CD117阳性的阳性率分别为80.5%和94.4%,而vimentin、SMA、S-100蛋白在肿瘤向平滑肌或神经方向分化时阳性.结论 GIST由梭形细胞或上皮样细胞构成,组织结构形态多变,但免疫表型完全一致;CD117及CD34阳性可作为GIST诊断及鉴别诊断的重要参考依据.     

子宫腺瘤样瘤的临床病理特点观察

目的探讨子宫腺瘤样瘤的临床病理特点、免疫组化表达特点及鉴别诊断,以提高子宫腺瘤样瘤的诊断水平。方法对22例子宫腺瘤样瘤进行临床病理及免疫组织化学观察,总结子宫腺瘤样瘤的临床病理特点和免疫组化特点。结果 22例子宫腺瘤样瘤患者,临床表现无特诊性,免疫组化显示:AEI/AE3、vimentin、alretinin阳性,ER、PR、cEA、CD31阴性。结论子宫腺瘤样瘤是一种少见的良性肿瘤,起源于浆膜间皮,临床表现及超声检查均易误诊、漏诊,病理和免疫组化检测CKpan及Calretinin有一定的特点,有助于和其他子宫疾病进行鉴别诊断。     

原发性脾血管肉瘤临床病理特征分析

目的 探讨原发性脾血管肉瘤的临床病理学特征及鉴别诊断.方法 收集2例原发性脾血管肉瘤患者的临床病理资料,进行组织学形态、免疫组织化学染色,并复习相关文献.结果 患者男女各1例,年龄分别为55岁和64岁,其中1例表现为左上腹持续性绞痛;CT示脾内低密度占位性病变,1例伴脾破裂及骨、肝转移.镜下肿瘤与脾组织分界不清,呈浸润性生长;瘤细胞卵圆形、梭形,部分上皮样,呈血窦样、裂隙状生长,细胞异型明显,核分裂易见.免疫组化主要表达Vim、CD34、CD31和F8.结论 原发性脾血管肉瘤罕见且临床症状不典型,需与脾脏其它肿瘤相鉴别,确诊依靠其特征性的组织学形态和免疫组化标记.     

唾液腺嗜酸细胞型黏液表皮样癌临床病理分析

目的探讨唾液腺嗜酸细胞型黏液表皮样癌的临床病理特征、诊断及鉴别诊断。方法对1例唾液腺嗜酸细胞型黏液表皮样癌进行临床病理学观察及组织化学、免疫组织化学染色标记,并通过相关文献复习,对病理诊断及鉴别诊断等进行分析。结果肿瘤由嗜酸性细胞、表皮样细胞、黏液细胞及中间型细胞构成,部分区域仅见被纤维结缔组织分隔呈片状、巢状或腺状排列的嗜酸性细胞,瘤细胞大小～致、形态温和,内含丰富的嗜酸性颗粒。组织化学染色：黏液分泌细胞及部分表皮样细胞PAS染色阳性。免疫组织化学染色：细胞角蛋白7（CK7）、细胞角蛋白20（CK20）阳性,CEA肿瘤细胞灶状显示阳性,神经元特异性烯醇化酶（NSE）、嗜铬蛋白A（CgA）阴性。结论唾液腺嗜酸细胞型黏液表皮样癌是黏液表皮样癌的一种亚型,极为罕见。组织学检查对本病的诊断具有重要作用,需要与唾液腺嗜酸性细胞腺瘤、多形性腺瘤及黏液性囊腺瘤进行鉴别。     

Cervical follicular dendritic cell sarcoma: a case report and review of the literature

Follicular dendritic cell (FDC) sarcoma is a rare tumour with a low-to-intermediate grade of malignancy. It frequently occurs in cervical, mediastinal and axillary lymph nodes. In approximately 30% of cases an extranodal localization has been reported (tonsils, oral cavity, mediastinum, liver, and spleen). Very little is known about possible treatment options and overall prognosis. This case reports a 66 year-old patient, who underwent surgical removal of a persistently enlarged right cervical lymph node. The histopathological examination revealed a spindle cell tumour with lymphocyte and plasma cell infiltrates. Neoplastic cells stained positive for CD21, CD23 and CD35, thus confirming the diagnosis of FDC sarcoma. The neoplasm recurred two years later and partial regression was achieved by IGEV rescue therapy. We briefly discuss clinical history, histopathological differential diagnosis and treatment options of FDC sarcoma.     

脾窦岸细胞血管瘤临床病理探讨

目的探讨脾窦岸细胞血管瘤（LCA）的临床表现、病理学形态、免疫表型特征、诊断与鉴别诊断,从而提高对该肿瘤的认识。方法对1例脾窦岸细胞血管瘤进行临床与病理形态学、免疫组化分析并复习相关文献。结果临床表现脾大、脾功能亢进、贫血及血小板减少。CT示脾实质内多个大小不等的类圆形低度变区,光镜下病变位于红髓内,界限清楚,相互融合成腔隙可形成彼此沟通成血管床,血管床囊性扩张,腔内岸细胞核无明显异型性。免疫组化vimentin（＋）、F8（＋）、SMA（＋）、CD31（＋）、CD68（＋）、CDl63（＋）、Lysozyme（＋）、S-100（-）、CD34（-）、CK（-）、Ki-67〈5％、D2—40（-）。结论LCA是一种罕见的脾血管源性肿瘤,病理学形态改变,免疫组化标记及影像学检查有助于诊断,结合文献报道,该肿瘤常伴发其他脏器的恶性肿瘤,对此类患者应密切随访,以除外肿瘤复发及转变恶性肿瘤的可能。     

磁共振检查对脾脏淋巴瘤的诊断价值

目的探讨磁共振检查对脾脏原发性淋巴瘤（PSL）的诊断价值。方法经手术病理证实的脾脏PSL患者3例,均采用磁共振检查,分析其影像学表现及诊断情况。结果3例手术后病理诊断均为B细胞型非霍奇金淋巴瘤,磁共振检查表现为多发肿块型2例,巨块型1例;磁共振平扫表现为脾脏不规则增大,呈等／稍长T1稍短T2信号巨大肿块影像,脾周围见线样长T1、长T2信号,脾门血管被包绕;增强扫描后,脾脏病变不均匀强化,呈等、低混杂信号,腹膜后病变呈中等均匀强化。免疫组化提示弥漫大B细胞型2例,肿瘤细胞CD20及CD19α弥漫（＋）、CD3、CD5散在（＋）、CD43（＋）、CD45RO（＋）、CD10（＋／-）、Mum（＋）、MAC387散在（＋）,B系淋巴浆细胞型1例,CD79eL（＋）、CD23（＋）、CD38（＋）、λ（＋）。结论PSL的磁共振表现具有特征性,有助于明确诊断,确诊依靠手术病理和免疫组化检查。     

Epithelioid haemangioendothelioma of the lung presenting with pulmonary nocardiosis

Epithelioid haemangioendothelioma of the lung is a rare tumour, originally described as intravascular bronchioalveolar tumour. The typical clinical findings are those of bilateral multiple pulmonary nodules in young or middle aged Caucasian women. Pulmonary nocardiosis is an unusual disease affecting patients with immunodeficiency or chronic obstructive lung disease. The first case of pulmonary epithelioid haemangioendothelioma (PEH) associated with pulmonary nocardiosis, in a 36-year-old woman presenting with progressive dyspnoea and fever, is described. The neoplasm was diagnosed by thoracoscopic lung biopsy and the histological diagnosis was confirmed by immunohistochemistry and electron microscopy. Pulmonary nocardiosis was confirmed by lung tissue culture. Following treatment with antibiotics, the patient's respiratory symptoms subsided. Two years after diagnosis she was asymptomatic and chest CT scans showed stable neoplastic disease.     

淋巴结外指状突树突状细胞肉瘤/肿瘤临床病理观察

目的探讨淋巴结外指状突树突状细胞肉瘤/肿瘤的临床病理学特征及鉴别诊断。方法对1例发生在横结肠系膜的淋巴结外指状突树突状细胞肉瘤/肿瘤进行光镜检查和免疫组化、电镜、流式细胞观察。结果光镜检查,肿瘤细胞由束状、编织状排列的胖梭形、卵圆形细胞和混杂的小淋巴细胞组成,界线不清,胞质略嗜酸性,核呈梭形或卵圆形,核膜清楚,染色质呈细颗粒状,可见核仁。免疫组化:S-100、CD68阳性,SMA、CD20、CD23灶性阳性,CD21、CD45RO、CD34、CD117、EMA、CK阴性,Ki67肿瘤细胞20%阳性。流式细胞:G0/G1(+)、G2(+)、S(+)提示为肿瘤,反应细胞增殖活性较强。电镜:肿瘤细胞具有复杂的指状突起,可见散在溶酶体,无Birbeck颗粒。结论指状突树突状细胞肉瘤/肿瘤是一种罕见的恶性肿瘤,鉴别诊断需借助免疫组化、电镜及流式细胞术。     

Congenital fulminant Kaposiform hemangioendothelioma of the leg

Kaposiform hemangioendothelioma is a rare locally aggressive vascular tumor associated with Kasabach Merritt syndrome. We present a case of congenital Kaposiform hemangioendothelioma of the leg in a female infant who was born to a mother treated with various medications including etanercept, a TNF antagonist, due to rheumatoid arthritis. The neonate suffered from a fulminant form of Kasabach Merritt syndrome with disseminated intravascular coagulation (DIC) resulting in multi-organ failure which led to her demise.     

Investigation of post-weaning changes in immunological parameters in male rats

Normal post-weaning changes in immunological parameters were investigated in male Crl:CD(SD) rats (n=7) for matching of ages with children (referential data). The animals received a single intravenous administration of keyhole limpet hemocyanin (KLH) 3mg/kg on day 1 and were euthanized on day 7 at 5, 7, 9, and 11 weeks of age. Furthermore, to investigate age-dependent differences in susceptibility to cyclophosphamide immunotoxicity, the animals were given oral cyclophosphamide 5mg/kgday from days 1 to 8 and intravenous KLH on day 3, and were euthanized on day 9 at the above ages. As a result, the post-weaning development pattern of a continuous increase until 9 weeks of age, followed by a mild decrease at 11 weeks of age, was commonly observed in white blood cell counts and all of its differential counts in peripheral blood, spleen weight, and total cell, CD3+, CD4+, CD8+ and CD45RA+ cell counts in the spleen. This pattern is similar to the development pattern of peripheral blood cell counts in infants, which mostly peaks at 6-12 months of age. Cyclophosphamide decreased almost all of peripheral blood cell counts and lymphocyte subset counts in the thymus and spleen at all ages, to similar degrees. However, decreases in serum anti-KLH IgM and IgG levels were greatest at 9 weeks of age. In conclusion, 9 (immunization at 8) weeks of age in rats was shown to be the most susceptible timing for cyclophosphamide immunotoxicity, likely corresponding to 6-12 months of age in infants.     

间变性淋巴瘤激酶阴性系统性间变性大细胞淋巴瘤穿刺活检病理诊断分析

目的 探讨间变性淋巴瘤激酶（ALK）阴性系统性间变性大细胞淋巴瘤（ALK阴性SALCL）穿刺针活检标本的病理诊断和鉴别诊断。方法 收集南阳市中心医院2019年1月至2022年1月经穿刺活检标本确诊为ALK阴性SALCL 4例，对其中临床病理资料完整的2例进行分析并行文献复习。结果 病例1，女性，69岁，首发为左颈部淋巴结肿大；病例2，男性，72岁，双腹股沟淋巴结肿大。2例高倍镜下可见标志性肿瘤细胞，细胞质丰富淡染，核包括肾形、马蹄形等多种形态。病例1细胞具有显著多形性；病例2低倍镜下见单行性瘤细胞呈片巢状黏附性生长，形态似尿路上皮癌。免疫组化染色2例均LCA（阳性），CD30（阳性），ALK（阴性），CK（阴性），CD20（阴性），PAX5（阴性），CD45RO（阴性）.经分子检测，2例TCR克隆性基因重排（阳性），病例1检测到TP63基因重排，病例2有DUSP22-IRF4基因重排。结论 ALK阴性SALCL临床少见，穿刺活检易误诊为低分化癌等多种低分化恶性肿瘤，熟悉其临床病理特点并识别出标志性肿瘤细胞，合理选择免疫组化抗体是确诊该肿瘤的关键。     

H1521, a novel derivative of 4-hydroxyquinoline-3-carboxamide, suppresses the development of lupus in mice by inducing Th1 cytokine profile in T cells

Transferring parental splenocytes into unirradiated F1 mice induces a chronic graft-versus-host disease (GVHD), characterized by the production of Th2 cytokines and immunocomplex-mediated glomerulonephritis resembling systemic lupus erythematosus (SLE). The effects of H1521, a new derivative of 4-hydroxyquinoline-3-carboxamide, were investigated in chronic GVHD lupus model. H1521 was administered to chronic GVHD mice for 10 weeks. Nephritic symptoms were monitored and cytokine expression in the spleen was detected. To clarify the direct effect of H1521 on CD4(+) T cell, CD4(+) T cells were isolated and co-cultured with H1521 under neutral and Th1 or Th2 driving conditions in vitro. H1521 (32 mg/kg) reduced the incidence of proteinuria by 50% in chronic GVHD mice. Ameliorated lupus symptoms and improved renal histopathology damage were also observed. Administration of H1521 had little impact on Th1 cytokine IL-2 and IFN-gamma or Th2 cytokine IL-4 and IL-10 mRNA expression. In contrast, severely deficient IFN-gamma production by concanavalin A-stimulated spleen cells in chronic GVHD mice was completely restored by H1521. In accordance with this, decreased T-bet mRNA expression became normalized with H1521 (32 mg/kg) treatment. In addition, in vitro studies demonstrated that H1521 preferentially favored Th1 differentiation in CD4(+) T cell and promoted IFN-gamma secretion in Th1 differential CD4(+) T cell. However, IL-4 secretion in naive or Th2 differential CD4(+) T cell was unaffected by H1521. In conclusion, H1521 can induce Th1 cytokine profile in CD4(+) T cells and has possible therapeutic value in Th2-predominant immune diseases.